How To Use CPT Code 84449

CPT 84449 describes the measurement of transcortin, also known as cortisol binding globulin, typically in patient serum. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 84449?

CPT 84449 can be used to measure transcortin, or cortisol binding globulin, in patient serum. This test is typically ordered by clinicians to evaluate patients whose cortisol levels do not align with their clinical presentation. Increased levels of transcortin may be present in pregnancy, oral contraceptive and estrogen therapy, while decreased levels may be seen in diseases requiring insulin, liver disorders, malnutrition, or inherited abnormalities.

2. Official Description

The official description of CPT code 84449 is: ‘Measurement of transcortin (cortisol binding globulin)’. There are no additional notes provided for this code.

3. Procedure

1. The lab analyst collects a specimen, typically patient serum, to perform the test.
2. The analyst mixes the specimen with specific substances to measure transcortin using methods such as radioimmunoassay.
3. The test utilizes a gamma radioactive isotope to precisely measure minute quantities of transcortin in the sample.
4. The analyst can measure the quantity of transcortin using a gamma counter.

4. Qualifying circumstances

CPT 84449 can be used for patients who require evaluation of their cortisol levels. It is not limited to testing for a specific condition. The test may be ordered for patients with cortisol levels that do not match their clinical picture. Increased transcortin may be present in pregnancy, oral contraceptive and estrogen therapy, while decreased levels may be seen in diseases requiring insulin, liver disorders, malnutrition, or inherited abnormalities.

5. When to use CPT code 84449

CPT code 84449 should be used when measuring transcortin levels in patient serum. It is appropriate to bill this code when evaluating patients whose cortisol levels do not align with their clinical presentation. This code should not be used for testing specific conditions, but rather to assess cortisol binding globulin levels.

6. Documentation requirements

To support a claim for CPT 84449, the following documentation is required:

• Patient’s clinical presentation and the need for transcortin measurement
• Specific substances and methods used for the test
• Date and time of the test
• Results of the transcortin measurement
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 84449, ensure that the test is performed to measure transcortin levels in patient serum. It is important to follow the specific guidelines provided by the payer regarding specimen collection, if applicable. There are no specific guidelines mentioned for reporting CPT 84449 with other codes.

8. Historical information

CPT 84449 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders a transcortin measurement to evaluate a patient with unexplained cortisol levels.
2. A patient on oral contraceptives undergoes a transcortin measurement to assess their hormone levels.
3. A patient with liver disease requires a transcortin measurement to evaluate their cortisol binding globulin levels.
4. A clinician orders a transcortin measurement for a malnourished patient with abnormal cortisol levels.
5. A patient with an inherited abnormality undergoes a transcortin measurement to assess their cortisol binding globulin levels.
6. A clinician orders a transcortin measurement to evaluate a patient with unexplained cortisol levels.
7. A patient on oral contraceptives undergoes a transcortin measurement to assess their hormone levels.
8. A patient with liver disease requires a transcortin measurement to evaluate their cortisol binding globulin levels.
9. A clinician orders a transcortin measurement for a malnourished patient with abnormal cortisol levels.
10. A patient with an inherited abnormality undergoes a transcortin measurement to assess their cortisol binding globulin levels.